According to settlement agreements released on July 9, 2018, Health Quest will pay the US $14.7 million and New York $880,000 to resolve allegations that it violated the federal and state False Claims Acts by submitting inflated and otherwise ineligible claims for Medicare and Medicaid reimbursement payments.
The settlements stem from three separate qui tam whistleblower lawsuits filed in the federal district court in the Albany. They are: US, ex rel. Folta v. Health Quest Systems, Inc., No. 1:15-cv-396; US, ex rel. Cleary v. Health Quest Systems, Inc., No. 16-cv-76; and US, ex rel. Betaudier and Carroll v. Health Quest Medical, Practice, P.C., et al., No. 1:16-cv-1344.
The settlements cover allegations, which Health Quest admitted, that:
From April 1, 2009 through June 23, 2015, Health Quest submitted claims for evaluation and management services but did not sufficiently document the services and billed two levels higher than supported by the medical records.
From April 1, 2011 through August 2014, Health Quest submitted claims for home health services that lacked sufficient medical records to support the claim, including documentation of a face-to-face encounter with a physician.
From March 1, 2014 through December 31, 2014, Health Quest subsidiary hospital, PHC, submitted allegedly false claims for inpatient and outpatient services referred to PHC by two orthopedic physicians, in alleged violation of the Physician Self-Referral Law and in violation of the Anti-Kickback Statute.
McInnis Law represented whistleblower Greg Folta, who filed the first of the three whistleblower lawsuits against Health Quest. Folta will immediately receive $967,651, representing 15% of the total recovered from his case by the US and New York. He has reserved the right to seek up to 25% of the proceeds he helped recover, according to his attorney Timothy J. McInnis, of NYC-based McInnis Law.
"This case is remarkable because three unrelated whistleblowers filed separate lawsuits using different lawyers and alleging different violations against the same hospital system," McInnis observed. "It really shows that the whistleblower procedures are working well, but it also shows something is grossly amiss with some hospitals and healthcare providers," noted McInnis.
CONTACT: Timothy J. McInnis, Esq., 1-212-292-4573, [email protected]
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SOURCE McInnis Law
